Sustained molecular remission in a patient with CML in blastic crisis receiving dose-reduced hematopoietic stem-cell transplantation followed by early withdrawal of cyclosporine and prophylactic use of interferon-α

Tamae Hamaki, Masahiro Kami, Shin ichi Momomura, Shin Mineishi, Eiji Kusumi, Yoshinobu Kanda, Jun ichi Ueyama, Shigesaburo Miyakoshi, Shin ichi Morinaga, Yoichi Takaue, Yoshitomo Mutou

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2 Scopus citations

Abstract

A 54-year-old man with chronic myelocytic leukemia in blastic phase received reduced-intensity transplantation (RIST) from an HLA-identical unrelated donor. The preparative regimen consisted of busulfan, fludarabine, and anti-thymocyte globulin. Graft-versus-host disease (GVHD) prophylaxis was cyclosporine alone. Because he had a high risk of relapse, we discontinued cyclosporine on day 37, but he did not develop any signs of acute GVHD. To induce GVHD and augment a graft-versus-leukemia effect, we initiated interferon-α therapy on day 80 to a maximum dosage of three million units five times a week. He achieved molecular remission on day 94 followed by the development of extensive chronic GVHD the severity of which paralleled to the dose of interferon-α GVHD gradually subsided after discontinuation of interferon-α and the patient remains in molecular remission 18 months after transplantation. This case suggests that early withdrawal of cyclosporine and the prophylactic use of interferon-α are promising in RIST for high-risk leukemia.

Original languageEnglish (US)
Pages (from-to)196-199
Number of pages4
JournalAmerican Journal of Hematology
Volume71
Issue number3
DOIs
StatePublished - Nov 1 2002

All Science Journal Classification (ASJC) codes

  • Hematology

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